Esophageal Cancer Pathology

  • Charles LeVea, MS, PhD is part of Roswell Park's team of gastrointestinal pathologists.

Why the Roswell Park Doctor You Never Meet May Be the Most Important Person on Your Care Team

Roswell Park pathologists are a critical component in cancer care. Dr. Kuvshinoff explains their role in determining a successful treatment plan.

Cancer patients see many doctors during the course of their treatment, but rarely do they meet the specialist who plays the most critical role in their outcome: the pathologist who diagnoses their cancer by analyzing samples of blood, tissue and body fluid. Precise diagnosis is what drives all subsequent decisions about treatment options and other patient choices.

The role of a pathologist in evaluation and diagnosis of Barrett’s metaplasia and possible progression to esophageal cancer cannot be overemphasized. All major medical societies recommend an expert gastrointestinal pathologist review all biopsies showing high-grade dysplasia.

Never before have pathologists been so critically important. Recent scientific developments have led to an explosion of information about markers and genomic analysis that helps to identify specific cancer types and pinpoint which one will be more aggressive or more likely to respond to a particular treatment than another type. One such example is the benefit of trastuzumab in cancers with high expression of HER2 Neu, an evaluation that requires highly-specialized pathologists with extensive experience.

How to Read Your Pathology Report

Cancer treatments are becoming more and more targeted, so an accurate and comprehensive analysis by a pathologist is critical in determining the best approach. Learn how to read your pathology report.

Game-Changer: Roswell Park pathologists reported that 10 percent of patients received a change in diagnosis after coming to RPCI from another care facility.

Second Look, World of Difference

Even if all you need is a second opinion from Roswell Park, we’re here for you! A second opinion is the best way to reassure you that your initial diagnosis of esophageal cancer is accurate and the recommended treatment strategy is right for you! Over a century, our specialists have successfully worked with community doctors, and are happy to discuss and share information, as needed.

When Should You Seek a Second Opinion?

Dr. Hochwald explains the importance of pathologist to determine the best course of treatment for esophageal cancer.

It’s always a good idea, but especially important if:

  • Your physician or pathologist has not provided you with a full, clear explanation of your pathology report, in a language you understand.
  • Your physician tells you that you don’t need a second opinion. A good doctor will suggest that you get another opinion if there are questions about your treatment or diagnosis. If your physician is offended, find a new doctor.
  • Your physician wants you to have surgery tomorrow. Almost nothing in the world of cancer care requires that kind of immediacy, except patients with acute leukemia; cases in which a tumor is compressing a vital structure, such as the heart or large blood vessels; or certain other rare conditions.

If you’re still not sure whether to ask for a second opinion, ask yourself:
Am I confident in the diagnosis or treatment options I’ve been given? Am I comfortable with my treating physician? Has my physician clearly explained all treatment options — not just the ones he or she prefers? Are there clinical research studies offering new treatments for my cancer? Was my cancer diagnosed at an office or community hospital setting or in a comprehensive cancer center? Does my insurance plan require a second opinion? If not, what type of coverage does it provide for second opinions?

To arrange for a second opinion, call 1-800-ROSWELL (1-800-767-9355) or fill out the online Become a Patient Form.